Individual
MR. MOSES SGUNRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3517 RIDGLEA CT, DEL CITY, OK 73115-1831
(405) 672-8201
Mailing address
3517 RIDGLEA CT, DEL CITY, OK 73115-1831
(405) 672-8201
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OK
101YM0800X
Mental Health Counselor
—
OK
101YP2500X
Professional Counselor
—
OK
106H00000X
Marriage & Family Therapist
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0409
—
OK
Enumeration date
11/19/2012
Last updated
12/05/2012
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